Prevention of substance abuse with college student veterans (2015)

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In the second decade of the Global War on Terrorism, more than a million veterans are returning to higher education. Readjustment from military to academic life, however, poses unique challenges for veterans who may be at increased risk for mental and substance disorders. Mental disorders, particularly post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), are prevalent among returning veterans and confer risk for substance-use problems. Indeed our research with student veterans in Central Texas, which identified disconcerting levels of mental illness (PTSD = 22%, MDD = 33%) and substance misuse (Alcohol = 48%, Drugs = 53%), suggests a high potential for comorbidity among this population. And yet, no known interventions have been designed to target substance abuse among student veterans experiencing psychological distress. Thus there is a critical need for the development of evidence-based interventions focused on the unique needs of this rapidly growing and at-risk population.

Our long-term goal is to develop a preventative intervention designed to target substance use among student veterans experiencing psychological distress. The specific objective of the proposed study, which represents our next logical step in the pursuit of that goal, is to pilot test an innovative intervention for student veterans experiencing psychological distress at the University of Texas at Austin. The intervention – a student-veteran adapted version of an empirically-supported, SAMSHA model program called “Keepin it REAL” (KIR), focuses on the development of decision-making and substance use resistance-skills.

A randomized pilot study will allow us to assess feasibility recruitment, randomization, retention and implementation by student veteran facilitators. Participants will be recruited through Veteran Student Services (SVS) which provides services to more than 600 student veterans at The University of Texas at Austin. Based on literature on adequate sample size for a pilot study, we will recruit 24 participants. Participants will be assigned using randomization procedures after baseline measures are completed. This allows for random allocation while balancing distribution between the two conditions based on categorical variables (i.e. gender, race/ethnicity). Self-report surveys will be administered once to participants pre-intervention and twice post-intervention. Pilot data will be used to demonstrate whether the effects of the intervention look promising and to begin examining the distribution of outcome variables to inform future research.

The study is significant because it is a necessary step toward the development of evidence-based interventions designed to address the needs of a growing and frequently underserved population in higher-education. It is innovative because it integrates an emphasis on overall mental health into a substance-focused intervention that has previously overlooked the interrelatedness of mental health and substance use.